Wu Yue, Zhan Yijun, Zhu Wenyan, Pei Jian
Department of Traditional Chinese Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Acupuncture, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Medicine (Baltimore). 2025 Jun 6;104(23):e42651. doi: 10.1097/MD.0000000000042651.
The incidence of Alzheimer's disease (AD) is gradually increasing in an aging society, imposing a heavy burden on society. Current studies have found that acupuncture therapy combined with donepezil has a good clinical effect in treating AD. We plan to conduct a systematic review and meta-analysis to evaluate the effectiveness of acupuncture combined with donepezil in AD patients.
Eight databases were searched for randomized controlled trials (RCTs) using acupuncture in combination with donepezil for the treatment of AD, from the establishment of the database to October 1st, 2023. The clinical efficacy rate, Mini-Mental State Examination, AD Assessment Scale for Cognitive Capacity, Skill Level on Activities of Daily Living, Montreal Cognitive Assessment, Behavioral Pathology in AD Rating Scale, and adverse events were mainly used to evaluate the outcomes. RevMan 5.4.1 software was used to evaluate the quality of the included studies and perform a meta-analysis.
A total of 12 RCTs were included. Meta-analysis showed that acupuncture combined with donepezil seemed to be more effective than donepezil monotherapy for treatment of AD in improving the clinical efficacy rate (relative risk = 1.35; 95% confidence interval [CI]: 1.17-1.56; Z = 4.10; P < .0001), the Mini-Mental State Examination score (mean difference [MD] = 3.28; 95% CI: 1.81-4.75; Z = 4.37; P < .0001), and the Montreal Cognitive Assessment score (MD = 6.04; 95% CI: 4.76-7.32; Z = 9.23; P = .00001), while reducing the AD Assessment Scale for Cognitive Capacity score (MD = -3.57; 95% CI: -3.94 to -3.20; Z = 18.91; P < .00001), the Skill Level on Activities of Daily Living score (MD = -2.52; 95% CI: -4.05 to -0.99; Z = 3.23; P = .001), and the Behavioral Pathology in AD Rating Scale score (MD = -4.04; 95% CI: -4.58 to -3.50; Z = 14.64; P < .00001).
Acupuncture combined with donepezil is an effective treatment which can improve cognitive ability and quality of life for AD patients. However, it is imperative to conduct more large-scale and high-quality RCTs in order to establish more definitive conclusions regarding this therapeutic approach in the future.
在老龄化社会中，阿尔茨海默病（AD）的发病率逐渐上升，给社会带来了沉重负担。目前的研究发现，针刺疗法联合多奈哌齐在治疗AD方面具有良好的临床效果。我们计划进行一项系统评价和荟萃分析，以评估针刺联合多奈哌齐对AD患者的有效性。
检索了8个数据库，以查找从数据库建立至2023年10月1日期间使用针刺联合多奈哌齐治疗AD的随机对照试验（RCT）。主要采用临床有效率、简易精神状态检查表、认知能力AD评定量表、日常生活活动技能水平、蒙特利尔认知评估、AD行为病理评定量表及不良事件来评估结局。使用RevMan 5.4.1软件评估纳入研究的质量并进行荟萃分析。
共纳入12项RCT。荟萃分析表明，针刺联合多奈哌齐在治疗AD时，在提高临床有效率（相对危险度=1.35；95%置信区间[CI]：1.17 - 1.56；Z=4.10；P<.0001）、简易精神状态检查表评分（平均差[MD]=3.28；95%CI：1.81 - 4.75；Z=4.37；P<.0001）及蒙特利尔认知评估评分（MD=6.04；95%CI：4.76 - 7.32；Z=9.23；P=.00001）方面似乎比单用多奈哌齐更有效，同时降低了认知能力AD评定量表评分（MD=-3.57；95%CI：-3.94至-3.20；Z=18.91；P<.00001）、日常生活活动技能水平评分（MD=-2.52；95%CI：-4.05至-0.99；Z=3.23；P=.001）及AD行为病理评定量表评分（MD=-4.04；95%CI：-4.58至-3.50；Z=14.64；P<.00001）。
针刺联合多奈哌齐是一种有效的治疗方法，可改善AD患者的认知能力和生活质量。然而，未来必须进行更多大规模、高质量的RCT，以便就这种治疗方法得出更确切的结论。
